Discussions By Condition: I cannot get a diagnosis.

Groin / Knee / Upper Buttock / Side Thigh Pain

Okay I am a 18 year old boy who has Groin / Knee / Upper Buttock / Side Thigh Pain all only on my Left side.

I had inguinal hernia's on both sides almost 4 years ago. About a year after the surgery I started to experience left groin pain. Specifically the pain was directly to the left of the p-enis where a normal inguinal hernia would be. It would mostly hurt in the mornings and when I would stand for longer periods of time. If I was sitting or moving I would be fine. Since then I have been to about 5 or so different Docs to find out whats wrong with me. I have been to physical therapy as well. The pain in the groin used to be pretty intense to where it was hard to live my everyday life. Oddly that specific pain isn't as bad anymore and more pains in different areas have come up. Now I have pain the goes down the the inner side of my left leg down to my knee. My knee hurts and I have pain on my the side of my thigh and upper buttock. The groin pain is there as well but not as intense. All on my left side. This pain comes any time. Still hurts more often when I stand and in mornings but also when I sit it hurts. When I ejaculate the pain that in in my inner leg is pretty bad.

All of the doctors I have seen think that it is related to complications from my surgery. I have had a CT scan done. They didn't find anything wrong they found a non malignant cyst on my left kidney. They all tested to see if I had another hernia and I don't. They put me on anti inflammatory, which helped the pain some when I was on them. But once I stopped the pain continued. They gave me a shot of steroids in my groin area, which did take all the pain away, but it only lasted for 2 days I believe. That was the last thing I have had done and it was about 3 months ago. lol I've been trying to find an answer for 3 years now.

I personally think that it is not related to my surgery. Or half of it is and half isn't.

I think it has to do with my whole left leg. I started to run recently. I've been running for about a month now. And what I've noticed is my left leg gets a lot more inflamed and sore. My right leg is always fine. My left leg has clicks and clunks when I walk on it. Like the clicks are up in my pelvis area, like where I would think my leg and pelvis would be connecting. My right leg doesn't. When I walk up stairs my left knee always clicks and my right knee doesn't.

Something else to consider. For a period of time I had the time do yoga. And the majority of my pain would not exist the next day. Which was nice. But I am too busy to do Yoga any more. Also when I was doing yoga I realized from some of the exercises that my lefts knee and my left leg as a whole is significantly weaker then my right.

Also I remember when I was in theater in Jr. High and High School, when ever I would perform and give speeches and whatnot I would always get in trouble for leaning to one side. I believe it was my left side. Is it possible that my left foot is shorter then my right?

Also I realized once when taking a bath one day, Just from looking down while sitting, it seems my gut was more over my left side. I don't know how to explain this really, like it kinda looks like the upper half of my body is placed like a little to the left on my pelvis I guess. lol idk.

Also when I lean over. If I just lean to the front I can feel my lower left back tense up and thats it. I don't feel my right side intill I go alot further. And if I l lean like to the right front side (like not all the way to the right and not all the way to the front) my lower left back gets real intense and I can't even go that far. But if I do the same going to the other side, my right lower back does just fine and can go alot further.

Sorry for all the information to come out really randomly but I have been having these pains for such a long time and have noticed just a lot of different things that may be associated with it so might as well write it down.

2 Replies:

As you suggested yourself, your pain may be musculoskeletal in origin. Are you thin, of average weight or overweight? Have you had plain x-rays of your pelvis/ left hip/ lumbar spine? Even young people like yourself can develop premature degenerative bone changes if there are abnormal or excessive stresses on the bone, and this could then lead to impingement of nerves.

If you have a complete examination and your doctors can’t find any other cause for your symptoms, then here is a suggestion. It might be a vascular problem. There is a condition called May-Thurnersyndrome. It is when the right iliac artery compresses the left iliac vein against the spine. This causes the blood to congest in the left leg because it can not normally pass the compression on its way back to the heart. It does not necessarily results in the pain at the compression site (if it does it gives a lower back pain); most often it causes pain or swelling or both in the left leg and/or buttock. (Sometimes the anatomical structures are different and this can happen on the right side). If you have a compression like this, after a while your circulatory system is trying to develop alternative veins. They are called collateral veins. Most often there are transpelvis collaterals (horizontal ones from left to right in pelvis), but some patients can develop them near the spine or even inside it. Then it can give pressure on nerves and give numbness and tingling sensation in legs. Another typical symptom is ambulating pain, the pain moves around depending on where the pressure is high at the moment. Also, the pain subsides when you lay down. This condition is vastly underdiagnosed. It is impossible to discover with ultrasound and even difficult to discover with venography (phlebography). The only certain way to discover it is by means of intravascular ultrasound (IVUS) where the probe is inside the vein. The best research has been done by Neglén and Raju in Jackson, Miss. The treatment is to put a stent inside the vein at the site of the compression. The typical patient is a young – middle-aged woman, previously healthy where the doctors have not found other explanation for the symptoms. If left untreated, there is a big risk of thrombosis either at the compression site in the left common iliac vein or in the left leg. Could this possibly help? The best of luck!